Gravity and syringe apparatus for intravenous injection of drugs.



GRAVITY AND SYRINGE APPARATUS FOR INTRAVENOUS INJECTION 0F DRUGS.

WMMMA M. ABRAMOVITZ.

APPLICATION FILED JAN.8,1913.

Patented Feb. 10, 1914.

MORRIS ABRAMOVITZ, OF BALTIMORE, MARYLAND.

GRAVITY AND SYRINGE APPARATUS FOR INTRAVENOUS INJECTION OF DRUGS.

Specification of Letters Patent.

Patented Feb. 10, 1914.

Application filed January 8, 1918. Serial No. 740,787.

To all whom it may concern:

Be it known that I, MORRIS ABRAMOVITZ, an intended citizen of the UnitedStates, residin in Baltimore city, in the State of Mary and, haveinvented certain new and useful Improvements in Gravity and Syringe,

Apparatus for Intravenous Injection of Drugs, of which the following isa specification.

My invention relates to a combined gravity and syringe apparatus for theintravenous injection of drugs into the body, and has particularreference to the injection of salvarsan for the treatment of syphilis.

Within recent years much attention has been given to the intravenousinjection of drugs and'to the provision of simple, cheap and time-savingapparatus for administering them. Such interest has been stimulatedgreatly by the comparatively recent discovery by Ehrlich and Hata of theantisyphilitic remedy called salvarsan. Inasmuch as the intravenousmethod of injection of this drug has been found in practice to be theleast painful and most efficacious, efforts have been directed towardthe perfecting of requisite apparatus and method.

, a column of fluid contained within the barrel of the syringe which isconnected with the inserted needle. All the previous appliances involveeither of these principles, though of course the details of constructionof the apparatus have differed in some respects in view of theircomplexity or simplicity. There are many objections to both of thesemethods which are readily seen and realized by those having occasion touse them in experimentation or practice. A seriously objectionablefeature of the gravity method is the amount of time consumed during theprocess of injection. The flow of liquid through a hypodermic needle bymeans of gravity is necessarily small and slow, and the propelling forcediminishes with the diminution of the liquid in the elevated container.Complete stoppage of the flow may occur, particularl toward the end ofthe injection, by the reii ex vaso-constriction of the vein, caused bythe irritation by the salvarsan, producing a pressure in the veinsufiiciently high to overcome the gravity force. In this contingencyblood clots might form in and around the needle. Further more the properentrance of the needle into the vein is with difiiculty ascertained,even when a piece of glass tubing is interposed between the end of thesupply tube and the needle, as one must rely entirely upon the backpressure of the blood in the vein to displace the liquid in the glasstube in opposition to the gravity propelling force, and this pressure ofthe blood is insuflicient. Some appliances have a detachable needlewhich is disconnected from the tubing allowing the blood to flow toindicate a successful puncture of the vein. The great disadvanta e ofthis is that during the act of then att-ac ing the tubing to the needle,the needle. ma be jarred and forced through the lower wa l of the veincausing a leakage of the liquid into the tissue, which would cause, asexperience has shown, extreme swelling of the tissue. Also during theact of attaching the tubing air bubbles might enter the needle and beforced by the liquid into the circulation sub-,

jecting the patient to the danger of an air embolus.

The syringe method has as many disadvantages. Most syringes adapted foruse in this particular operation have metallic parts particularly atwo-way stop cock. As salvarsan is quickly oxidized'as well as oxidizingits passage through such a syringe would form-poisonous ox-ids whichwould be injected into the patients blood. In addition to this, such asyringe may be used on the left arm as in this position the stop cockwould be on top and accessible, but its use on the right arm isinconvenient as the stop cock would be necessarily on the bottom anddifficult of access.

The operation of retracting the piston of the syringe in order toascertain the proper entry of the needle into the vein naturally drawsthe blood into the syringe, part of it adhering to the walls andclotting. When the liquid is then injected the clots will either clogthe needle entirely or pass into the circulation. This likewise causesdanger of an embolu's. As .the capacity of a syringe is ordinarily nomore than fifty c. c. it is necessary to interrupt the injectionfrequently in order to refill the barrel. The time then consumed inclosing the stop cock, filling the barrel and opening the stop cock isfrequently sufiicient to cause the formation of blood clots. Furthermoreair may enter and be injected, causing great danger to the patient. Anassist-ant is indispensable, which adds another disadvantage to thismethod, as it increases the cost to the operator and the patient.

The object of the present invention is to provide an apparatus whichwill combine in one .device the syringe and gravity methods, obviatingtheir objectionable features.

Another object is to provide a device of this character which willinsure a continuous flow 0 liquid.

. An impo tant object is to provide a device which is capable ofinjecting liquid at gravity pressure and a pressure higher than gravitywithout any cessation of the flow.

A further object is to provide a device of this character in which theentry of the needle into a vein may be ascertained without danger of,the formation of a blood clot.

Still another object is to provide a device of this character in whichthe needle is held rigid upon a patient preventing movement of theneedle and puncturing of the walls of the veins.

A further object is to provide a device of this character which isexpeditious in operation, and capable of being handled by one operator.

A very important object is the provision of a device of this characterhaving one ofits elements adapted to serve as an air trap to prevent theinjection of air bubbles into the vein.

Other objects and advantages such as cheapness and simplicity willappear in the course of the specification.

Referring to the drawings forming a portion of this specification and inwhich similar numerals are employed to designate corresponding partsthroughout the several views: Figure 1 is a general view of my improvedapparatus illustrating its use, Fig. 2 is a plan View of a specificcannula used in connection therewith, and Fig. 3 is a side elevation ofthe same.

Referring more particularly to the drawlngs, 1 represents the arm of apatient to be treated, and 2 indicates a tourniquet applied thereto.

The numeral 3 desi ates a container of any desired size and ormedpreferably of glass. The container is adapted to be supported by meansof a hanger formed on a ring 5 encircling the container. Graduations maybe marked on the container itself, but on account of cheapness I preferto use an unmarked container, and employ a graduated rod 6 formed on thering 5 and extending longitudinally to the bottomef-the container.

A flexible tube 7 preferably of rubber is connected with the container 3and one branch 8 of a specially constructed Y cannula 9. A pinch cook 10is disposed upon said tube 7. A second tube 11 is connected with theother branch 12 of said'cannula and a glass syringe 13, comprising thebarrel 14 and piston 15. To the main lumen 16 of said Y cannula 8 isconnected by means of a tube 17, a hypodermic needle 18 of any Wellknown or preferred type. The cannula and needle are adapted to besecured in place upon the arm by means of a strip of adhesive plaster19.

The cannula 9 is an important part of my invention as it is designed toserve as a trap for any air that may be in the apparatus. The branches 8and 12 have their ends corrugated or provided with bulbous protuberances20 for attachment with the rubber tubes 7 and 11, while the main lumen16 has a perfectly cylindrical bore with merely a projection 2l upon theupper edge of its end to engage the tube 17 firmly. Upon the main lumen16 near its union with the branches 8 and 12 is formed a bulb 22 whichprojects above the cannula and beyond its sides, thus making it ofgreater diameter in every way than the bore of the cannula. In practiceI have found it advisable to make the bulb 2213f about 2 c. 0. capacity.It will be. understood that all parts of the apparatus in contact withthe liquid used are of glass or rubber, except the needle.

The operation of m apparatus is as follows: After sterilization, thecontainer 3 is filled with distilled water and suspended from a gravitypole. By opening the pinch cock 10, the water is allowed to run through7 tube 7 and out driving out the air from this portion of the apparatus.The pinch cook 10 is then closed. The barrel 14 of the syringe is thenfilled with distilled Water and the air driven out by pressing thepiston 15 upward. Then the connections with the Y cannula 9 are made asillustrated. By lowering the cannula and opening the pinch cock 10 theair is driven out of branch 8 of the Y. The piston 15 of the syringe 13is now pressed forward driving water and thus the remaining air out ofthe branch 12 of the Y and the main lumen 16.- The apparatus freed ofair is then ready for use.

The tourniquet 2 is then applied to the arm as shown, and after theveins have distended the needle 18 is inserted. A successful puncture isindicated by a reflex column of blood in the base of the Y 9. As soon asthis is noted, the cannula 9 is secured upon the patientsarm by means ofthe adhesive strip 19 placed at the junction of the Y with the needle.The tourniquet is then removed.

With the pinch cock 10 closed the piston 15 is forced downwardly slowlythereby reinjecting the blood into the vein and introducing water.Meanwhile the solution, such as salvarsan, has been poured into thereceptacle 3 with what water remained therein. When the syringe isemptied of water, it is refilled by opening the pinch cock 10 andpulling back the piston 15, slowly. lVhen the syringe 13 has beenrefilled the pinch cock 10 is closed and the contents of the syringeexpelled into the vein. This is continued until the container 3 isempty, or until the desired amount has been injected.

If any bubbles of air have found their way into the apparatus fromleakage or any other cause, they will rise to the top of the bulb 22 andthe liquid will pass out through the Y leaving the bubbles caught in thebulb 22.

Experiment has proved that when the piston is drawn back to refill thesyringe the cavity formed by the bulb 22 being above the level of themain lumen not only serves as a trap for the air bubbles but also ismore or less filled with the liquid from the container and with the air,if any therein, produces a gravity pressure which with the gravitypressure of the container forces a steady flow of the liquid through theneedle while the syringe is being filled, whereby the blood is preventedfrom entering the needle during the operation of refilling the syringe.Thus it is seen that at no time is there any stasis in the system. Theimportance of this steady current can not be overestimated, since itprevents the formation of clots and the clogging of the needle duringthe refilling of the syringe.

The bulbous portion 22 of the cannula is a positive safeguard againstthe passage of bubbles into the vein, as they are bound to rise withinthe bulb and remain there while the liquid flows. continuously throughthe cannula.

By combining a gravity fluid propeller with a syringe or hand forcedfluid propeller in the manner described into a one unit force I effect acontinuous flow through the needle whereby the syringe may be refilledwithout breaking the continuity of the flow through the needle andthereby preventing the blood entering the needle while the syringe isbeing refilled.

With my apparatus all of the fluid or solution may be withdrawn from thecontainer and the operation performed in a few minutes while with thegravity method alone the operation is very slow, and the gravitypressure becomes gradually less, as the quantity of the solution becomesreduced, until it becomes too weak to overcome the reflexvaso-constriction of the vein, when the flow ceases and a considerableportion of the solution remains in the container.

Furthermore, the transparency of my Y tube, one arm of which isconnected with the tubing from the solution container, enables theoperator to see when the tubing is completely empty by noticing the aircoming down in the arm of the Y tube. This transparency of my Y tubealso enables the operator to see if theneedle is in the vein, by drawingthe piston of the syringe slightly when the puncture is made until theblood appears directly in front of the needle, and to then immediatelyinject it back into the vein before it becomes clotted. Furthermore,with my apparatus one person can carry out the entire operation, thusdispensing with an assistant or the presence of an assistant, and it canbe applied equally well to either the right or left arm.

Having thus described my invention what I claim is:

1. An intravenous injector comprising a gravity reservoir, a syringe, acommon outlet provided with a hollow upwardly extending protuberance andconnected with said reservoir and said syringe, and a hypodermic needleconnected with said common outlet.

2. An intravenous injector comprising a Y, a gravity reservoir connectedwith one branch of said Y, a syringe connected with the other branch ofsaid Y, a hollow upwardly extending bulb on said Y, and a hypodermicneedle connected with the main lumen of said Y.

3. An intravenous in'ector consisting of a gravity reservoir, a tube, ahollow upwardly extending bulbous projection on said Y tube, a tubeconnecting said reservoir with said Y tube, a cut off device disposed onsaid second mentioned tube, a syringe, another tube connecting saidsyringe with said Y tube, and a hypodermic needle connected with said Ytube.

4. An intravenous injector consisting of a gravity reservoir, a Y tube,a tube connecting said reservoir with said Y tube, a cut off devicedisposed on said second mentioned tube, a syringe, another tubeconnecting said syringe with said Y tube, and a hypodermic needleconnected with said Y tube, said Y tube being provided with an enlargedhollow upwardly projecting portion between the fork of said Y tube andthe end of the main'lumen.

5. In an intravenous injector, thecombination of a gravity reservoir, aY tube, a

tube connecting said reservoir with said Y 6. In an intravenousinjector, comprising a gravity reservoir, a syringe and a hypodermicneedle; a Y tube having its branches connected with said reservoir andsaid syringe and its main lumen connected with said needle, said Y tubebeing provided with a hollow upwardly extending projection between thefork and the end of the main lumen.

7. In an intravenous injector, comprising a gravity reservoir, a.syringe and a hypodermic needle; a Y tube having its branches connectedwith said reservoir and said syringe and its main lumen connected withsaid needle, said Y tube being of transparent material and provided witha hollow upwardly extending projection between the fork and the end ofthe main lumen.

In testimony whereof I hereto aflix my signature in the presence of twowitnesses. MORRIS ABRAMOVITZ, M. D. Witnesses:

SoL. H. EMANUAL, HENRY W. BATEMAN.

